Budget cuts hit home in foster care

Four and a half years ago, Melinda stumbled across a flyer at the Good Food Store advertising Montana’s foster child program. She’d always planned to adopt, but jumped at the chance to take in a child in need. After more than a year of waiting, she welcomed a son into her home, a “cool kid,” she says, who was born with significant medical issues that required specialized care and visits to specialists outside Missoula.

Melinda, who asked that her real name not be used to protect the child’s identity, doubts she could have adjusted to those needs without help from Missoula’s Foster Child Health Program. The program — a collaboration between the city-county health department, Providence Medical Center and Montana’s Child and Family Services — aims to support the health needs of foster children and offer guidance for foster parents. Last fall, budget cuts prompted the state to cancel its contract with the program, cutting off $65,000 in funds. Health Department Director Ellen Leahy says she’d hoped to keep the program going on existing county funds, but last week she announced scale-backs to staff. One part-time nurse was laid off, and the program’s caseload will be narrowed to focus on newborns to 5-year-olds, as well as teens about to age out of foster care.

“Four months into it, we were just bleeding our budget too much, and we had to start planning about how we are going to carefully transfer these kids out of service,” Leahy says. She expects the active caseload to decrease from an average of 60 cases a month to between 5 and 15.

Missoula’s Foster Child Health Program started about 15 years ago as a pilot backed by a federal grant. In 2011, Leahy says, it was resurrected with funding from the state and the Missoula County Commission, and since then has served an estimated 600 foster children. The program was replicated in Billings and Great Falls in 2016.

“These kids have a lot of acute and particularly chronic conditions,” she says of the program’s importance. “It’s surprising that children this young can have chronic conditions, but they do.”

Judith Birr has been with the program since its inception. She’s also now its sole nurse. When the services first kicked off, she says, her caseloads were large, and foster kids’ medical histories were scattered. Time has made the process smoother and more thorough, she says — an important improvement given the rise in drug-affected children coming into state custody. Birr also can’t overstate the level of help many new foster parents need, a point echoed by Melinda.

“People become foster parents because they want to help children and they believe they can help a child,” Melinda says. “If there’s not adequate support for that family … that belief becomes fractured.”

Leahy says the program will likely have to look to private foundations for additional funding. However, with budget cuts affecting the entire health-care community, she fears she won’t be the only one looking that direction for help.